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Chemical Shift Effect Predicting Lymph Node Status in Rectal Cancer using High-Resolution MR Imaging with Node-for-node Matched Histopathological Validation1Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
Synopsis
To evaluate the value of chemical shift effect (CSE), as well as other criteria for the prediction of lymph node status. Lymph nodes harvested from transversely whole-mount specimens were compared with in vivo and ex vivo images to obtain MR characteristics including CSE, as well as other predictors of 255 benign and 35 metastatic nodes. Our results revealed that CSE is a reliable predictor for differentiating benign from metastatic lymph nodes. Other predictors of nodal location, border, signal intensity and minimum distance to rectal wall were also proved to be useful for the diagnosis.
Objectives
To evaluate the value of chemical shift effect (CSE), as well as other criteria for the prediction of lymph node status.Materials and Methods
Twenty-nine patients who underwent radical surgery of rectal cancers were studied with preoperative and postoperative specimen MRI. Lymph nodes were harvested from transversely whole-mount specimens, and compared with in vivo and ex vivo images to obtain a precise slice-for-section match. Preoperative MR characteristics including CSE, as well as other predictors were evaluated by two readers independently between benign and metastatic nodes.Results
255 benign and 35 metastatic nodes were obtained for node-by-node analysis. 71.4% and 69.4% of benign nodes were detected with regular CSE for two readers respectively, whereas 80% and 74.3% of metastatic nodes with absence of CSE. The inter-rater agreement was excellent between readers (κ=0.803). The predictors of nodal location, border, signal intensity and minimum distance to rectal wall were also proved to be useful for the diagnosis but with AUCs lower than that of CSE.Conclusions
CSE is a reliable predictor for differentiating benign from metastatic lymph nodes. Additional criteria are needed to be taken into account when it is difficult to determine the nodal status by using only a single predictor.Acknowledgements
No acknowledgement found.References
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